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Breastfeeding & bottle feeding

Hi, I have a 4-month old son and I started going back to work in the beginning of January so he started bottle feeding expressed milk I pump at work.
He was already being fussy when breastfeeding so I was struggling but now he seems to be distracted so he doesn't eat much on my breast.
At his 2 month check up his weight was on 65th percentile and now he's on 30th. (Height and head are both growing nicely) So I was told by his ped to try feed an oz more everyday. I have been every 2 hrs at least and 1-1.5 hrs when he's still awake and/or possible.
My husband is the caregiver while I'm at work and he thinks baby eats better from the bottle so he wants to bottle feed if he's fussy breastfeeding but I don't want to do that because I'm worried about the supply and I also would feel like i am rejected.
We don't know if he's really eating more from the bottle or he's just less fussy with the bottle...
I pump about 16-18oz at work and he eats 15-16oz usually. I would like to keep my supply and our bond with the baby during nursing but should I still bottle feed when I'm home and can breastfeed for him to grow??

Re: Breastfeeding & bottle feeding

Hi Chi,
I am still new at nursing and haven't pumped at all yet so I hope you get some good advice from some more experienced mamas, but one thing you could consider when you have a day at home is the 24 hour cure to increase your supply and help baby to remember what he is doing at the breast - you and baby, in bed, skin to skin, doing nothing but nursing and napping for 24 hours. No pumping, no bottles, just lots of nursing. Hubby or someone else brings you food, takes care of chores, etc, you just nurse, eat, stay hydrated and rest. Here is some more information http://www.pomegranate-midwives.com/...our%20Cure.pdf

Re: Breastfeeding & bottle feeding

Thank you!
That's a relief to hear for me. I feel like the things I'm doing right now is right... to keep the supply.
I DO try to feed him more often once I come back from work and when I'm not working. THank you so much reassurance!

Re: Breastfeeding & bottle feeding

Hi Chi,
I think there are a couple issues here. First, you mention struggles with breastfeeding. Could you give some more details about that? It is important to make sure that everything is going smoothly with breastfeeding. For example, if there is a latch problem or tongue tie or something like that, it should be addressed. Have you seen a lactation consultant, preferably an IBCLC (international board certified LC)? Is nursing painful?

In general, whenever possible you want to nurse rather than pumping and feeding baby the bottle. For one thing, there are benefits to nursing at the breast. Second, it's harder to maintain supply if you are only pumping, and pumping is annoying and a pain! Of course if you are apart from baby at work, pumping lets you maintain your supply and provide breastmilk for your baby during the separation. But there's no reason that you should not nurse when you are together with baby - again assuming that everything is going well with breastfeeding.

You do want to be careful not to overfeed baby with the bottle during the day, as that will reduce baby's motivation to nurse with you at night and can cause a decrease in supply. But if you are apart from your baby for 10 or 11 hours then the amount he is drinking sounds about right.

It's not uncommon for baby's weight to drop in percentiles. Is your doctor using the WHO growth charts? The fact that head circumference and and height are both increasing suggests that there may not be a growth problem - or a problem with your milk. While pumping is not necessarily a reliable measure of supply (for example, pump output from a single pumping session), the fact that you are reliably able to pump 16-18 oz a day suggests your supply is just fine.

Re: Breastfeeding & bottle feeding

Hi, thank you for your response!
Struggles I mean are the baby being fussy at breast. He might not want to eat at the moment or get distracted or I can't tell most of the times... I saw a LC a few times when I had latching problems, engorgement/oversupply issues. Nursing itself is not painful at all and once he starts eating and cooperating it's nice and smooth.
He might be just a snacker...? He usually eats for 10 mins at most during the day and 15-20 mins when he's sleepy and kind of pacifying towards the end. So I feel like he needs to eat more/longer.
Yes, pumping is a bit annoying since I would have to prep the equipment and clean and stuff. Plus it doesnt feel very good, kind of makes me feel like a cow...
I think the doc is using the WHO growth charts. I thought the baby wouldn't grow in height/head circumference if there's growth problems... but I may be wrong.
He also has at least 6 wet diapers a day and 1-2 dirty diapers. (Sometimes he skips a day for poo but I understand it's normal)
I nursed 8 times yesterday within 24hrs. Usually every 2 hours or less during the day and 3-4 hours at night.
To be honest it's sometimes hard for me to decide when he's done eating. Ex. He faces the other way because he's done or he's simply distracted... or he cries because he's done and doesn't want to be in the position or he's too hungry.
Did I answer all your questions? I really appreciate your response and support.

Re: Breastfeeding & bottle feeding

Okay, so it sounds like things are actually going well. That's great that you have no pain with nursing and that things are going smoothly once he is eating. Keep in mind that babies get more efficient with nursing as they get older. So a 4 month old may well be getting his fill in 10 minutes - or even less! Does your pediatrician's office ask you how many minutes baby nurses at each meal? I ask that because that's what my pediatrician's office asks. The thing is, how long a baby nurses does not tell anything about how much he is drinking in a session. Go by what baby is telling you, not by the clock. If baby comes off the breast and you offer the other breast and he's not interested, then he's telling you he's done, for the moment. The best way to make sure baby is getting enough overall in the day is to offer frequently. Baby won't nurse if he's not hungry so you can't overfeed him (another advantage of the breast, vs the bottle), but you want to make sure he is having plenty of opportunities to nurse when he is hungry. 8 times in 24 hours is on the lower end of sessions/24 hours - many babies (but not all) will nurse 10 or more times in 24 hours. Now, eight times may be perfectly normal for you and your baby, but doesn't hurt to offer more.

In terms of baby being a "snacker": all breastfed babies are snackers - in that they eat frequent, small meals - usually 2 or 3 or 4 oz - and that stays the same throughout the year. Breastfed babies do NOT go on 4 hour (or longer) schedules of feeding the way a formula-fed baby might. They eat just like you describe - every couple hours, maybe more often at times, less often at others (ie, maybe a longer stretch of 3 or 4 hours at night, if you are lucky!) and that is all perfectly normal.

It sounds like you are doing great, really - definitely do NOT switch to all pumping!

Re: Breastfeeding & bottle feeding

Thank you for reassurance! I did notice the fast letdown in earlier months on nursing and it still might be the problem. He pulls off once after letdown happens sometimes.
Laid back nursing position looks a bit tricky but I will try and see how it works with my baby. He often fusses when he's laid on the nursing pillow. I might have traumatized him when he was younger because I was really overproducing and having fast letdown! haha

Yes my ped's office asks how long/often I nurse too. Good to know the length doesn't matter how much he's eating. And a huge relief to hear that 10 mins or less could be enough for him to finish eating!
Do you think I should take a break if he's really fussy? I think he might not be interested in eating at the moment but also he might be mad because he's really hungry or something... I will definitely try to nurse him more often when I'm with him.
I was also told by the pediatrician to start sleep training. He told me not to nurse when he wakes up in the middle of the night so he learns to fall back to sleep. But I'd think he should be hungry if he wakes up in the middle of the night...??
Like you said babies don't go over 4 hours. My baby slept for 6 hours straight the other night for the first time but it must be very rare.

Re: Breastfeeding & bottle feeding

Feeding frequency is much, much more important than feeding duration. Most babies need to feed a minimum of 8x per day in order to get their needs met, and many will feed far more often than that.

Do you think I should take a break if he's really fussy? I think he might not be interested in eating at the moment but also he might be mad because he's really hungry or something... I will definitely try to nurse him more often when I'm with him.

IMO, nursing should always be the first mothering tool you reach for when your baby is fussy. If you offer and he declines, then you move on to some other soothing technique.

I was also told by the pediatrician to start sleep training. He told me not to nurse when he wakes up in the middle of the night so he learns to fall back to sleep. But I'd think he should be hungry if he wakes up in the middle of the night...??

Bad advice! First, you know your baby better than the pediatrician, who sees him for 20 minutes every couple of months. If you think he's hungry when he wakes in the middle of the night, he probably is. Second, he is very young and he probably does need to nurse in the middle of the night. Third, you're working and that means that a lot of the time you're relying on the pump to maintain your supply. Every bit of nursing you do- especially of it's in the middle of the night!- will help you keep your workday pump output where it needs to be. Fourth, your baby will benefit from practice time at the breast. Night-nursing is a great way to get a fussy or distracted baby to nurse, since many babies will nurse better when they are relaxed and sleepy. Fifth, the concern that brought you here was a weight issue. Why on earth would the pediatrician want you to reduce the number of times your baby nurses when there is concern over his weight? Many babies take in a significant number of calories during their nighttime nursing sessions. And sixth, let's say you do night-wean your baby. Then what are you going to do when he wakes up because of teething or because he's mastering a new developmental milestone or because he's hungry? The dirty little secret of sleep training is that most people end up sleep training their babies over, and over, and over again. They have to face a crying baby in the middle of the night without their most valuable parenting tool: nursing.

Re: Breastfeeding & bottle feeding

I couldn't agree more with mommal!

Your pediatrician sounds a lot like mine. My doctor is a great doctor but he gives terrible advice when it comes to breastfeeding-friendly practices - so I just ignore him when it comes to breastfeeding and sleep. He had his third baby when my second was a baby and told me that he convinced his wife to move their baby into his own room when he was 4 weeks old. He also told me when my first was six months old that there was "no reason" baby should be nursing at night. Well, there is a reason. It's normal for babies to wake up at night and want to nurse - nursing is the most soothing thing there is for them. And I totally agree with what mommal says about nighttime nursing and maintaining supply - it's always been my mantra that nighttime nursing is a working mom's best friend! If you take away nighttime nursing, and you're away at work all day, that doesn't leave many hours to nurse baby. Yes, it's tiring, but it's less tiring if you have baby in bed with you or in the room and you nurse baby lying down in your bed. And definitely, if there is any concern about weight gain, I agree that you want to nurse more frequently rather than less.

Re: Breastfeeding & bottle feeding

Thank you mommal and bfwmomof3!
I've had a really stressful day yesterday nursing my baby. He didn't want to nurse all morning and cried so hard! We ended up giving him a bottle and he went to sleep.
I tried to nurse him right after he wakes up from naps, that was the only time he would nurse!! So nighttime nursing is a lot less stressful for me now...
When I wanted to nurse him more often, he didn't want to nurse so often so it's really tough I really didn't know what to do... We tried different positions, but he didn't like any of them! When he's sleepy he can be in the cradle position. I really hope it's just a temporary thing that he didn't want to nurse (at least he nursed at night/very dark and when he was sleepy) Lots of tears and I almost wanted to quit nursing...
Anyway... I want to be able to nurse him in a sling but I haven't had any success... did any of you try? He might be more comfortable being nursed in a sling because he already likes being in it but I just can't make it work well.